Mortality outcomes in individuals with MASLD versus MASLD and increased alcohol intake.
Alcohol use
Cancer
Mortality
NHANES
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
22 Aug 2024
22 Aug 2024
Historique:
revised:
03
08
2024
received:
08
05
2024
accepted:
09
08
2024
medline:
23
8
2024
pubmed:
23
8
2024
entrez:
23
8
2024
Statut:
aheadofprint
Résumé
Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a leading cause of chronic liver disease worldwide. A new entity termed MetALD has also been described and is defined as individuals with MASLD and increased alcohol intake. However, the natural history of MetALD compared with MASLD is unknown. We aimed to compare longitudinal outcomes in patients with MASLD versus MetALD. This study was performed using data from the National Health and Nutrition Examination Survey from 2011 to 2018. MASLD patients (defined by the United States Fatty Liver Index > 30) who met cardiometabolic criteria including body mass index (BMI) > 25 (BMI > 23 in Asians), hypertension, diabetes mellitus, dyslipidemia, and hypertriglyceridemia were included. MetALD was defined as MASLD with increased alcohol intake (3-6 standard drinks per day in males; 2-5 standard drinks per day in females). A comparison of overall, cardiovascular, cancer-related, and other causes of mortality in patients with MASLD versus MetALD was performed. A total of 2838 individuals with MASLD and 2557 individuals with MetALD were included with a median follow-up time of 56 months. MetALD patients were at increased risk of cancer-related mortality compared with patients with MASLD (hazard ratio 1.32; 95% confidence interval 1.14-1.53; P < 0.01). However, there was no significant difference in overall, cardiovascular, and other causes of mortality. Patients with MetALD were at higher risk for cancer-related mortality than MASLD. Close attention to regular cancer surveillance and accurate classification of alcohol consumption in individuals with diagnosed MASLD is warranted to help improve patient care and outcome.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a leading cause of chronic liver disease worldwide. A new entity termed MetALD has also been described and is defined as individuals with MASLD and increased alcohol intake. However, the natural history of MetALD compared with MASLD is unknown. We aimed to compare longitudinal outcomes in patients with MASLD versus MetALD.
METHODS
METHODS
This study was performed using data from the National Health and Nutrition Examination Survey from 2011 to 2018. MASLD patients (defined by the United States Fatty Liver Index > 30) who met cardiometabolic criteria including body mass index (BMI) > 25 (BMI > 23 in Asians), hypertension, diabetes mellitus, dyslipidemia, and hypertriglyceridemia were included. MetALD was defined as MASLD with increased alcohol intake (3-6 standard drinks per day in males; 2-5 standard drinks per day in females). A comparison of overall, cardiovascular, cancer-related, and other causes of mortality in patients with MASLD versus MetALD was performed.
RESULTS
RESULTS
A total of 2838 individuals with MASLD and 2557 individuals with MetALD were included with a median follow-up time of 56 months. MetALD patients were at increased risk of cancer-related mortality compared with patients with MASLD (hazard ratio 1.32; 95% confidence interval 1.14-1.53; P < 0.01). However, there was no significant difference in overall, cardiovascular, and other causes of mortality.
CONCLUSIONS
CONCLUSIONS
Patients with MetALD were at higher risk for cancer-related mortality than MASLD. Close attention to regular cancer surveillance and accurate classification of alcohol consumption in individuals with diagnosed MASLD is warranted to help improve patient care and outcome.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIDDK NIH HHS
ID : K08 DK132312
Pays : United States
Informations de copyright
© 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
Références
Danpanichkul P, Ng CH, Muthiah MD et al. The silent burden of non‐alcoholic fatty liver disease in the elderly: a global burden of disease analysis. Aliment. Pharmacol. Ther. 2023; 58: 1062–1074.
Rinella ME, Lazarus JV, Ratziu V et al. A multi‐society Delphi consensus statement on new fatty liver disease nomenclature. J. Hepatol. 2023.
Danpanichkul P, Suparan K, Kim D, Wijarnpreecha K. What is new in metabolic dysfunction‐associated steatotic liver disease in lean individuals: from bench to bedside. J. Clin. Med. 2024; 13.
Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology 2023; 77: 1335–1347.
Le MH, Yeo YH, Li X et al. 2019 Global NAFLD prevalence: a systematic review and meta‐analysis. Clin. Gastroenterol. Hepatol. 2022; 20: e28.
Chew NWS, Ng CH, Tan DJH et al. The global burden of metabolic disease: data from 2000 to 2019. Cell Metab. 2023; 35: e3.
Danpanichkul P, Ng CH, Muthiah MD et al. Metabolic syndrome and metabolic dysfunction‐associated steatotic liver disease in premenopausal women: global trends and projections to 2040. Mayo Clin. Proc. 2024.
Danpanichkul P, Auttapracha T, Sukphutanan B et al. The burden of overweight and obesity‐associated gastrointestinal cancers in low and lower‐middle‐income countries: a Global Burden of Disease 2019 analysis. Am. J. Gastroenterol. 2024; 119: 1177–1180.
Kanwal F, Neuschwander‐Tetri BA, Loomba R, Rinella ME. Metabolic dysfunction‐associated steatotic liver disease: update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice guidance on nonalcoholic fatty liver disease. Hepatology 2023.
Eslam M, Newsome PN, Sarin SK et al. A new definition for metabolic dysfunction‐associated fatty liver disease: an international expert consensus statement. J. Hepatol. 2020; 73: 202–209.
Kalligeros M, Vassilopoulos A, Vassilopoulos S, Victor DW, Mylonakis E, Noureddin M. Prevalence of steatotic liver disease (MASLD, MetALD, and ALD) in the United States: NHANES 2017–2020. Clin. Gastroenterol. Hepatol. 2023.
Blomdahl J, Nasr P, Ekstedt M, Kechagias S. Moderate alcohol consumption is associated with advanced fibrosis in non‐alcoholic fatty liver disease and shows a synergistic effect with type 2 diabetes mellitus. Metabolism 2021; 115: 154439.
van Kleef LA, de Knegt RJ, Brouwer WP. Metabolic dysfunction‐associated fatty liver disease and excessive alcohol consumption are both independent risk factors for mortality. Hepatology 2023; 77: 942–948.
Rice BA, Naimi TS, Long MT. Nonheavy alcohol use associates with liver fibrosis and nonalcoholic steatohepatitis in the Framingham Heart Study. Clin. Gastroenterol. Hepatol. 2023; 21: e2.
Danpanichkul P, Ng CH, Muthiah M et al. From shadows to spotlight: exploring the escalating burden of alcohol‐associated liver disease and alcohol use disorder in young women. Am. J. Gastroenterol. 2024.
Liu Y, Sun Z, Wang Q, Wu K, Tang Z, Zhang B. Contribution of alcohol use to the global burden of cirrhosis and liver cancer from 1990 to 2019 and projections to 2044. Hepatol. Int. 2023; 17: 1028–1044.
Danpanichkul P, Suparan K, Ng CH et al. Global and regional burden of alcohol‐associated liver disease and alcohol use disorder in the elderly. JHEP Rep. 2024; 6: 101020.
Danpanichkul P, Chen VL, Chaiyakunapruk N et al. Socio‐economic association of alcohol use disorder and cardiovascular and alcohol‐associated liver disease from 2010 to 2019. Aliment. Pharmacol. Ther. 2024.
de Carvalho RM, Szabo G. Role of the inflammasome in liver disease. Annu. Rev. Pathol. 2022; 17: 345–365.
Babuta M, Nagesh PT, Datta AA et al. Combined Insults of a MASH diet and alcohol binges activate intercellular communication and neutrophil recruitment via the NLRP3‐IL‐1beta axis in the liver. Cells 2024; 13.
NCHS. National Health and Nutrition Examination Survey Data. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008–2018.
Khang AR, Lee HW, Yi D, Kang YH, Son SM. The fatty liver index, a simple and useful predictor of metabolic syndrome: analysis of the Korea National Health and Nutrition Examination Survey 2010–2011. Diabetes Metab. Syndr. Obes. 2019; 12: 181–190.
Bedogni G, Bellentani S, Miglioli L, Masutti F, Passalacqua M, Castiglione A, Tiribelli C. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006; 6: 33.
Huang X, Xu M, Chen Y et al. Validation of the fatty liver index for nonalcoholic fatty liver disease in middle‐aged and elderly Chinese. Medicine (Baltimore) 2015; 94: e1682.
Ruhl CE, Everhart JE. Fatty liver indices in the multiethnic United States National Health and Nutrition Examination Survey. Aliment. Pharmacol. Ther. 2015; 41: 65–76.
European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity, European Association for the Study of the Liver. EASL‐EASD‐EASO clinical practice guidelines on the management of metabolic dysfunction‐associated steatotic liver disease (MASLD). J. Hepatol. 2024.
Kanwal F, Neuschwander‐Tetri BA, Loomba R, Rinella ME. Metabolic dysfunction‐associated steatotic liver disease: update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice guidance on nonalcoholic fatty liver disease. Hepatology 2024; 79: 1212–1219.
Meza V, Arnold J, Diaz LA et al. Alcohol consumption: medical implications, the liver and beyond. Alcohol Alcohol. 2022; 57: 283–291.
Diaz LA, Fuentes‐Lopez E, Idalsoaga F et al. Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes. J. Hepatol. 2024; 80: 409–418.
Zhong L, Chen W, Wang T et al. Alcohol and health outcomes: an umbrella review of meta‐analyses base on prospective cohort studies. Front. Public Health 2022; 10: 859947.
Molina‐Montes E, Ubago‐Guisado E, Petrova D, Amiano P, Chirlaque MD, Agudo A, Sánchez MJ. The role of diet, alcohol, BMI, and physical activity in cancer mortality: summary findings of the EPIC Study. Nutrients 2021; 13: 4293.
Di Castelnuovo A, Costanzo S, Bonaccio M et al. Alcohol intake and total mortality in 142 960 individuals from the MORGAM Project: a population‐based study. Addiction 2022; 117: 312–325.
Aberg F, Byrne CD, Pirola CJ, Mannisto V, Sookoian S. Alcohol consumption and metabolic syndrome: clinical and epidemiological impact on liver disease. J. Hepatol. 2023; 78: 191–206.
Sakaguchi S, Takahashi S, Sasaki T, Kumagai T, Nagata K. Progression of alcoholic and non‐alcoholic steatohepatitis: common metabolic aspects of innate immune system and oxidative stress. Drug Metab. Pharmacokinet. 2011; 26: 30–46.
Kudryavtseva AV, Krasnov GS, Dmitriev AA et al. Mitochondrial dysfunction and oxidative stress in aging and cancer. Oncotarget 2016; 7: 44879–44905.
Minato T, Tsutsumi M, Tsuchishima M et al. Binge alcohol consumption aggravates oxidative stress and promotes pathogenesis of NASH from obesity‐induced simple steatosis. Mol. Med. 2014; 20: 490–502.
Seo YG, Polyzos SA, Park KH, Mantzoros CS. Fibrosis‐4 index predicts long‐term all‐cause, cardiovascular and liver‐related mortality in the adult Korean population. Clin. Gastroenterol. Hepatol. 2023; 21: 3322–3335.
McNally BB, Rangan P, Wijarnpreecha K, Fallon MB. Fibrosis‐4 index score predicts concomitant coronary artery diseases across the spectrum of fatty liver disease. Dig. Dis. Sci. 2023; 68: 3765–3773.
Chew NWS, Ng CH, Chan KE et al. FIB‐4 predicts MACE and cardiovascular mortality in patients with nonalcoholic fatty liver disease. Can. J. Cardiol. 2022; 38: 1779–1780.
Angulo P, Bugianesi E, Bjornsson ES et al. Simple noninvasive systems predict long‐term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology 2013; 145: 782–789.e4.
Hagstrom H, Nasr P, Ekstedt M, Stal P, Hultcrantz R, Kechagias S. Accuracy of noninvasive scoring systems in assessing risk of death and liver‐related endpoints in patients with nonalcoholic fatty liver disease. Clin. Gastroenterol. Hepatol. 2019; 17: 1148–1156.e4.
Onnerhag K, Hartman H, Nilsson PM, Lindgren S. Non‐invasive fibrosis scoring systems can predict future metabolic complications and overall mortality in non‐alcoholic fatty liver disease (NAFLD). Scand. J. Gastroenterol. 2019; 54: 328–334.
Janjua M, Knuiman M, Divitini M, McQuillan B, Olynyk JK, Jeffrey GP, Adams LA. Alcohol consumption and cardiovascular outcomes in patients with nonalcoholic fatty liver disease: a population‐based cohort study. Hepatol. Commun. 2022; 6: 526–534.
Kashiwagi K, Yamaguchi A, Shiba S et al. Moderate alcohol consumption is not associated with subclinical cardiovascular damage but with hepatic fibrosis in non‐alcoholic fatty liver disease. Alcohol 2020; 89: 1–7.
Castellana M, Donghia R, Guerra V et al. Performance of fatty liver index in identifying non‐alcoholic fatty liver disease in population s tudies. A meta‐analysis. J. Clin. Med. 2021; 10.
Kim D, Wijarnpreecha K, Dennis BB, Cholankeril G, Ahmed A. Types of physical activity in nonalcoholic fatty liver disease and all‐cause and cardiovascular mortality. J. Clin. Med. 2023; 12.